Update on Gestational Diabetes Test

What a week!  Even though I had a great appointment last Friday, I have felt the stress of uncertain times for the past week.  Not knowing what comes after a failed gestational diabetes (GD) test put me in a little bit of a tailspin.  Plus, thinking about the social stigma that comes with the word diabetes had me all frustrated and upset.  But, God works for the good of those who love Him, and He has worked good for me!

I can honestly say that this is the first day in a few weeks that I have been up willingly without taking a nap.  Currently, I don't feel like I am going to throw up (my stomach is actually growling at me) and I have energy - at least a little.  Now, it is only the first day, but I am thinking positively!

So, Friday the call came saying I had a positive test for GD and I had to wait until Monday to call back.  So, Monday morning, I called and learned that the normal ranges for the GD test are below 140.  My number was 181!  A bit high, ok, a lot high!  Anyway, I was hoping to take the 3 hour test on Tuesday and have it over and done with.  The lab personnel informed me that I had to follow a special diet for 3 days before the test and that they would put the diet in the mail (as I was unwilling to drive the 32 miles one way just to pick it up).  Anyway, I got the diet in the mail on Tuesday and had spoken with a good friend on Monday who had GD during her last pregnancy.  She spiked interest in me and I began researching.  After looking at the diet, and the instructions for the 3 hour test, I realized I was not eating enough food during the day.  Research told me two things:

1) With a 1-hour number above 180, all I would technically need would be a fasting blood glucose level to confirm a positive GD diagnosis.

2) If unable to follow the "diet," results would be skewed and would either end up in a false positive or a false negative.

I called my doctor's nurse on Tuesday, armed with knowledge.  Knowledge is power, right!?!  So, after presenting my case, she spoke with the doctor and together the 3 of us agreed that the 3 hour test would be unnecessary.  The agreement is that I will say I have GD and follow those guidelines.  I was honestly at peace with the situation.  So...that leads me to today.

I received a call this morning asking if I could make a 10:30 appointment to meet with a registered dietitian to go over everything related and required with GD.  I made the appointment, received education, and came home.  The dietitian said that new protocol is that if you fail 1 test, you have GD and a 2nd test is not needed!  I had made a good decision!  The OB clinic that I go to does not yet follow this protocol.  

A couple of interesting facts:

1) Insulin requirements during pregnancy are usually 3 times more than what is needed normally.  GD results when insulin production does not keep up with what is required.

2) GD occurs during pregnancy only.  It usually disappears following delivery.  However, there is an increased risk of developing diabetes later in life, so special screenings are done on a yearly basis.

3) GD affects people of all shapes and sizes.  Overweight, thin, tall, short - you name it!

4)  Treatment of GD is more for the health and safety of the babies than for the mother.  It is amazing how God created tiny little beings to know when they need to produce their own insulin to fight high glucose levels - even only at 25 weeks gestation!

So, the journey continues.  I press on with the prize at the end being a safe delivery of our twins. I press on knowing some of the social stigma that will come at me from people I know and people I don't know.  However, I also press on knowing that the end result is two healthy babies to care for, nurture, and love all the rest of life!

I will try to update on my progress sometime in the next couple weeks.  Hopefully, I will be feeling better!

Update and Prayers

I found out this afternoon via a message on my voicemail that I failed my 1 hour blood glucose test. This means there is a possibility that I have gestational diabetes.  In order to find out, I have to drink double the solution and have a 3-hour blood glucose test.  From what I understand (research wise as I haven't talked with my dr's office yet), I will have 4 blood draws - one before the solution, then one every hour for the next 3 hours.  

Please pray that this test comes back normal!  I am not gaining much weight the way it is and am struggling with eating as I am not feeling well.  I am lucky if I can get one meal to stay down and even then it isn't very much because of all the pressure on my tummy! 

I will update again after I have the 3-hour test - hopefully the first part of next week!  Also, no results yet on my hemoglobin (iron level)...hopefully, that will be normal - otherwise adding vitamins or even straight iron tablets will have to happen - and with how I am feeling, it could be interesting!

Thanks and will chat soon!

The long awaited update - 24 wks 1 day

It has been a month since I last posted and truly not much has changed.  I did have a doctor's appointment today and everything is going excellent - status quo!

It was great to be able to see the babies and hear the heartbeats again - oh so reassuring!

Baby A (on the bottom) -

Heartbeat - 143

Approximate weight - 1 pound 12 ounces (69th percentile) a gain of 14 ounces from last month

Measuring - 25 weeks 4 days

Baby B (on the top) -

Heartbeat - 130

Approximate weight - 1 pound 14 ounces (77th percentile) a gain of 1 pound from last month

Measuring - 25 weeks 2 days

As for me - blood pressure was 110/78 (very good) and urine cultures were fine.  Cervical measurements showed that there is less than a 5% chance that I will go into preterm labor before 32 weeks.  After 32 weeks, according to my doctor, the only risk is if my water breaks, I start spotting, or the babies start showing signs of distress.  So, it is just one appoitment and one day at a time.

Basically, everybody is doing well. I only gained two pounds during the last month, which my doctor was still pleased with.  But, as you can tell, it was all baby weight, minus 2 ounces.  She would like to see a little more weight gain, but isn't too worried at this point in time, especially with how well the babies are growing! 

I did do my glucose tolerance test (gestational diabetes) today as well as some other blood work. 

I will update more later, just wanted to get the current information about the babies out there!

20 wks and the BIG u/s!

20 weeks gone and 20 weeks to go!  It is amazing to me that I am already at that halfway point.  I have officially reached my 1st goal of 20 weeks!  In the early stages, I wondered if I would even make it that far, and now I have...my next goal is 24 weeks and my next appointment!  If I set those little goals to accomplish, then it seems more manageable.

Now, for the information you are all waiting for....

Oh, wait, a picture or two first!  :-)

                                     First signs of Spring

        My two precious daughters - what one does so does the other!

                   My oldest - Blessing - 3 years and 9 months

                             My youngest - Joy - 21 months

Now, onto the doctor's visit today...

Baby A's heartbeat - 143 and Baby A's weight - 14 oz
Baby B's heartbeat - 154 and Baby B's weight - 14 oz

As for developmentally, they are right on track.  According to my doctor, they are measuring beautifully and are in the 60th to 70th percentile for their "age."  She did say that this will probably start to taper off when I hit my 3rd trimester as twins don't grow as fast due to the amount of room available.  As for all of their parts - they are all there and are looking wonderful.  We saw all 4 chambers of the heart on both babies and their spine (which looks closed and shows no signs of defects).  We got to see the babies in 3D for a few minutes and I was able to count fingers and toes on almost all of the appendages.  It is hard to keep track of what I caught and what I didn't!

As for me and how I am doing - I am measuring 32 weeks at my 20 week appointment.  This explains why I have been so short of breath lately.  Just walking up to our 2nd floor and I am winded.  My doctor said just to take it easy and make sure to take plenty of breaks and not push so hard that I am completely unable to catch my breath.  She also said that I am easily winded because 2 babies are taking oxygen from my blood to help sustain them and that my body is naturally having to work harder.  I guess it just means that I need to give myself grace and have plenty of patience as things will continue to take longer and longer!  As for my cervix, it is perfect.  It hasn't changed at all since my last ultrasound 3 weeks ago and my doctor is 80% positive that I will not have pre-term labor and the babies won't come early because I can't carry them.  She will be 100% positive after my next cervical ultrasound in 4 weeks.  The magic number is 2.4 cm in length.  Right now, I am at 4.6 cm in length, so it is looking good!  Now, she did warn me that this doesn't mean that the babies won't come early.  If they start to show signs of stress or if I develop high blood pressure, then we will have to make decisions.  But, she is fairly certain carrying them won't be an issue!  As for my blood pressure, 110/76 which impressed the doctor as well.  And, yes, I did gain more weight.  3 more pounds!  So, the doctor was also pleased with that!

Basically, all is well.  Next appointment is May 7, so will know more then!  So great to know that the babies are developing well and things are right on track!

Normal AFP

Just wanted to let everyone know that I just got a phone call from my doctor's office.  My AFP test was normal!  Praise God!  My doctor had told me that about 75% of the AFP tests done in women expecting twins or more shows positive.  So, this had me a bit concerned that I might have to go through further testing, if the doctor was concerned and I was so inclined.  I left it in God's hands and knew that He would take care of everything!

For those of you who are curious and would like more information about the AFP test.  The following information was taken from the WebMD website (http://www.webmd.com/baby/alpha-fetoprotein-afp-in-blood)

An alpha-fetoprotein (AFP) blood test checks the level of AFP in a pregnant woman's blood. AFP is a substance made in the liver of an unborn baby ( fetus). The amount of AFP in the blood of a pregnant woman can help see whether the baby may have such problems as spina bifida and anencephaly. An AFP test can also be done as part of a screening test to find other chromosomal problems, such as Down syndrome (trisomy 21) or Edwards syndrome (trisomy 18). An AFP test can help find an omphalocele, a congenital problem in which some of the baby's intestines stick out through the belly wall.

Normally, low levels of AFP can be found in the blood of a pregnant woman. No AFP (or only a very low level) is generally found in the blood of healthy men or healthy, nonpregnant women.

The level of AFP in the blood is used in a maternal serum triple or quadruple screening test. Generally done between 15 and 20 weeks, these tests check the levels of three or four substances in a pregnant woman's blood. The triple screen checks alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), and a type of estrogen (unconjugated estriol, or uE3). The quad screen checks these substances and the level of the hormone inhibin A. The levels of these substances-along with a woman's age and other factors-help the doctor estimate the chance that the baby may have certain problems or birth defects.

Screening tests are used to see what the chance is that your baby has a certain birth defect. If a screening test is positive, it means that your baby is more likely to have that birth defect and your doctor may want you to have a diagnostic test to make sure.

Happy St. Patrick's Day and more!

What a beautiful afternoon!  The sun is shining, my two girls are napping, and I feel good enough to get a few things accomplished (mainly computer business)!

First off, Happy 52nd Birthday to my dear father!  Happy anniversary to my dad and step-mom too!  I pray that you have a blessed day!

Now, onto baby news.  I had another appointment today!  I had forgotten how uneventful "regular" baby checks can be.  So, really I don't have any exciting news.  I was hoping to be able to scan a picture in of the ultrasound but didn't even get a hard copy of a picture today!

So, the babies heartrates are 150 and 154.  So, very close to each other....both the same sex, I don't know!  I had a chance to find out the sex today, but decided against it, for this time.  I guess I just wasn't in the right mood.  Maybe next time.  Sorry to all of you who are more anxious than me about finding out....:-)

I also had a cervical check today, and there was no sign of pre-term labor.  This is a good thing, meaning my body is doing a great job of carrying the two little ones right now.  This is a normal ultrasound test my doctor does on women expecting twins.  I will have two more of these - one in 3 more weeks at my next appointment and the last one 4 weeks after that.

Other than that, the only other exciting news is that I have actually gained weight.  3 pounds!  This is incredible since with my other 2 pregnancies I gained nothing.  The doctor doesn't know if it is just blood volume, baby weight, uterus growth, and placenta/amniotic fluid or if it is actual weight gain.  Nevertheless, she was excited to see a little gain!  I am very surprised as I am still sick.  However, I can say I am feeling better than I was back in December/January/February.  I am only getting sick 2 times a day on average.  This is a good thing!  Maybe it will go away all together and I will have a "normal" rest of the pregnancy!

My next appointment is Friday, April 9.  3 weeks and 2 days away.  At this appointment, they will do another cervical check and will have do a full ultrasound.  At this ultrasound, they will do an anatomy check - checking to make sure the babies are developing correctly.  This doesn't mean I will find out the sexes, just means they will check the heart, lungs, liver, appendages, spine, head, etc. I am excited!  I will probably take a DVD to this appointment and have them record it so my husband can see it, since he will more than likely be at work.

Finally, to those who are curious as to how Joy is doing, she is much better.  The doctor started her on some prednisone on Monday to help with the wheezing.  It definitely was pneumonia.  The doctor couldn't believe how much air she was moving on Monday.  She never suspected pneumonia because Joy wasn't exchanging enough oxygen on Friday.  We are so glad we took her to the ER and had further testing done so she could heal quicker!

Finally, a quick little Joy story....I love to put her to bed, either at nap or night-night time.  We rock and she lays across my arms.  I know she is ready to go to sleep when I ask her for a kiss and she leans up and kisses me.  I then carry her to her crib and lay her down.  I get her all covered up and then put my hand on her forehead and tell her I love her.  I move my hand down her cheek and go to leave the room. Joy always tells me, "I wove you too mommy!"  It is so sweet!  I am cherishing these cuddles with Joy so much!  I know all too soon that those cuddles will not be the same.  Blessing is so sweet too!  She has been kissing the babies in mommies tummy.  Today, however, I took her to the ultrasound to hopefully have her connect and understand more why mommy doesn't have the energy and can't do what she used to do.  Anyway, she told the ultrasound technician that "I changed my mind.  I only want 1 baby instead of two."  However, when the technician asked her if she wanted a brother or a sister, she still answered with "A brother for Joy and a sister for me!"  I love my two girls!

God's blessings to you and I pray you have a Happy St. Patrick's Day today!

Patience

PATIENCE - an 8 letter word which is hard to do

I remember a sign in my mom's kitchen growing up that stated "God grant me patience - BUT I want it right now!" As I have been going along in this parenting journey, I am really starting to understand this. Part of me wonders if God is really trying to teach me patience right now, or if I am truly that bad with patience that I need lessons on patience.  So, below is some lessons on patience I have had the past few weeks...

First off, I have been exhibiting patience (among other things) while waiting for my next OB appointment. Usually, at this stage in the game, baby appointments are about 4 weeks apart, give or take a few days.  Well, the span between my last appointment and my next one is 6 weeks!  The first 4 weeks went by very well - I wasn't anticipating anything.  This week and I am sure next week, are just dragging on.  There are periods of time during the day that I wonder if the babies are ok, if they are growing properly, etc.  This has also been a test of faith - I give the babies to God every morning and know that He is in control of them and my life.  Some days are easier than others, but it is a work in progress - a testing of patience!

Secondly, I have been working on exhibiting patience with my oldest daughter.  I don't know if it is her age or her personality or a combination of both, but she has truly been challenging me these past few weeks.  I have had to take a step back, retake "control," and exhibit patience while disciplining her.  Sometimes I wonder if I expect too much of her, while other times I know I don't expect enough of her.  I really think it is one of those things that is a give and take.  However, I will say, that I have made amazing strides the past 2 weeks.  So much that now my dear husband is almost to the point that I was 2 weeks ago (a parenting breakdown).  We had a chat last night, after he battled our oldest going to bed, about how our daughter knows what to do and how to do it to get daddy beyond the point of frustration and without patience.  We talked about the importance of not showing our frustrations and exhibiting calmness and extreme patience while disciplining.  I have found that it makes the biggest difference!  So, yes, a test of my patience - one that I am passing almost 90% of the time.  The last 10%, usually in the evenings, I am still working on - a work in progress!

Thirdly, patience in the awaiting of Spring.  If there was a sign about Spring similar to the patience sign, I could have it right now.  I enjoy every season - which is part of the reason we live in the middle of Iowa instead of Arizona - but at the end of winter, it is a challenge of patience.  I am ready for the Spring flowers to start poking through the ground - for blossoms to start blooming - for grass to turn green and need mowed - for warmth and not drowned ground so my children can play outside - for sunshine - for the ability to go on picnics and not freeze - etc.  I think you get the idea....I am in the process of making a fresh fruit pizza to remind me of Spring.  This past week I have made several "summer" meals for supper including grilled stuffed pork chops, sauted zucchini, steaks, baked potatos, etc. It truly has helped to lift the mood and has helped me to have more patience while awaiting Old Man Winter to go away!

Finally, I think just patience to get things accomplished overall.  It is amazing how extremely tired I have been this pregnancy  - more so than with my other two.  I have periods during the day where I can accomplish things and periods where I have no energy and need to lie down.  Needless to say, only about half of what I want to accomplish during the day actually gets done.  This is a test of patience for me - remembering what is important and knowing that the rest can wait until tomorrow or the next day or the next day...

So, God truly is teaching me patience, in many ways.  But, I still want it right now!  :-)